Tuesday, December 6, 2016

The future of state Medicaid is in doubt

Governor Gina Raimondo‘s “Reinventing Medicaid” paid off with
the announcement of nearly $130 million in federal funds that will help
facilitate health care professional training and alternative payment models.
But questions remain: Are we training students for good paying jobs or poverty?

Will Medicaid survive Trump?

Governor
Gina Raimondo and Health and Human Services Secretary Elizabeth Roberts announced
that Rhode Island has received $129.7 million in federal funds that will be
used to “implement new Medicaid payment
models that result in better health outcomes and better-quality care, and to
strengthen the state’s healthcare workforce pipeline.”

“These
federal funds will help us continue to shift our publicly financed healthcare
system towards alternative payment models that ensure we’re paying for value,
rather than volume of services. They will also help us invest in the healthcare
workforce required to realize our shared vision of better care, healthier
people, and smarter spending,” said Roberts during the State House announcement
of the funds.

Senator Sheldon Whitehouse and
Representatives James Langevin and David Cicilline were on hand
to be lauded for their efforts in securing the federal funds.

Cicilline
struck a cautious note about the funds and about Medicaid in general, saying,
“I think we are in for some challenging times for the next couple of years,
depending on the new administration’s view on Medicare and
Medicaid, certainly our current Speaker [Paul
Ryan] has articulated a different vision of ending the guarantee of
Medicare and turning it into a voucher requiring older Americans to go out and
buy insurance which would be catastrophic, so, hopefully the example of Rhode
Island will be evidence, ammunition, frankly, for us to make the case
that this current system when administered properly can produce results in a cost
effective way and help us continue to Medicaid and Medicare and other essential
programs.”

CCRI (Community
College of Rhode Island) President Meghan
Hughes said that “training and educating Rhode Island’s health care
professionals is one of the things CCRI does best… This partnership, and the
financial investments being made in education will help our students advance.”
Hughes said that 90 percent of health industry students who attend CCRI stay in
Rhode Island, raising families, purchasing homes and paying taxes. Investing in
CCRI is an investment in the state’s economy.

But
what are we paying these students once they graduate? Patrick Quinn, executive
vice-president of SEIU 1199NE,
representing 29,000 workers in RI, MA and CT, wrote that while news of the
federal investment of $130 million is welcome, “…far too often both locally and
nationally we see redundant administrative costs and outrageous executive
compensation packages while front line caregivers struggle to get by and
provide for their families. A handful of people have become “Medicaid Millionaires,” while the
rest of us – consumers, patients, residents, and direct care staff – have been
left behind.”

Medicaid
was developed to help combat poverty, Quinn reminds us. “Low wages plague
long-term care jobs, causing high turnover among our workforce and harming our
efforts to enhance the quality of care.

“That’s
why workers in nursing homes, community programs for individuals with
developmental disabilities, and home care across the country and in Rhode
Island have joined in the Fight
for $15 and a Union.”

However,
looking at the state’s priorities for the money, “stabilizing the workforce
with living wages, good benefits, and a union” (Quinn’s words) is not a
priority.

Instead,
what Raimondo and Roberts are calling “Reinventing
Medicaid 2.0 – Health System Transformation, Rhode Island” will spend
its money to improve
health outcomes for the one in four Rhode Islanders enrolled in Medicaid.

For
example, over the long term the funds will help transform Rhode Island’s
healthcare system so that:

-More Rhode Islanders get well-coordinated care that better addresses all of
their needs – mental, physical, and social – so they can stay healthy and avoid
more expensive hospital visits and procedures.

-More elderly Rhode Islanders get the long-term support they need to age with
independence in their homes and communities, whenever possible.

-Rhode Islanders who require a more intensive level of care and support receive
high-quality, better-coordinated care that improves outcomes at hospitals and
nursing homes.

Focus
on better coordination of care through our managed care organizations and new
provider partnerships.

Ensure
Rhode Island has the healthcare workforce it needs by investing in strategic
partnerships between Rhode Island’s public higher education institutions and
healthcare providers to train students with the skills they need for 21st
century healthcare jobs.

Support
better care, healthier people, and smarter spending.

Raimondo
was introduced by John Oleksa,
a Medicaid recipient, “whose life was changed by more
intensive, better coordinated care to help him gain back his mobility and get a
personal care attendant who can help him stay in his home and live
independently.” Oleksa said that the care he received helped him, “get his life
back.”

Steve Ahlquist is an
award-winning journalist, writer, artist and founding member of the Humanists
of Rhode Island, a non-profit group dedicated to reason, compassion, optimism,
courage and action. The views expressed are his own and not necessarily those
of any organization of which he is a member. atomicsteve@gmail.com
and Twitter: @SteveAhlquist

Thought for the day

Nothing funny about tired Saturday Night Live on Fake News NBC! Question is, how do the Networks get away with these total Republican hit jobs without retribution? Likewise for many other shows? Very unfair and should be looked into. This is the real Collusion!

Individual One’s tweet at 4:52 AM - 17 Feb 2019 after a long, hard day of playing golf at Mar-A-Lago on Day Two of our “national emergency.”

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